| NPI | 1154851921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA61265495) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA059022) |
| 363AM0700X Physician Assistant, Medical (Licence: WA PA61265495) | |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2023-02-02 |